Anna Adhikar Abhiyan (AAA) is a network of about 100 organizations across Maharashtra, campaigning on the right to food security and sovereignty while Jan Arogya Abhiyan(JAA) is the state level campaign platform working for Health rights of people in Maharashtra since over a decade.

AAA and JAA are jointly organizing a protest demonstration on 22nd March, 2013 at Azad Maidan, Mumbai, in collaboration with Anna Adhikar Abhiyan to press for urgent action on important policy demands regarding Health services and Food security in Maharashtra. Around 2000 people from various parts of the state including Right to Food activists, Health rights activists, health professionals and social activists will be participating in this mass protest and ‘Dharana Andolan’ to demand prompt action on various outstanding policy issues.

This is to request you to participate in the Dharana Andolan’ on 22ndMarch 2013 at Azad maidan from 1.00 pm to 4.00 pm.

3. Reform, Universalise and Strengthen the Public Distribution System.

4. Fourteen essential items and millets must be distributed through the PDS

5. Every card holder to be eligible to obtain twelve subsidised gas cylinders per year.

6. Stop the entry of foreign companies in retail trade.

Healthcare: Main demands

7. Adopt a state specific ‘Maharashtra Clinical Establishments Act’ to regulate private hospitals, based on the national act but with inclusion of provisions for protecting Patient’s rights, along with participatory review and grievance redressal mechanisms.

8. Stop privatisation of radiological services in Medical college and District hospitals.

9. Overcome gross shortage of essential medicines in all public health facilities by implementing the ‘Tamil Nadu model’ in comprehensive manner at earliest.

10. Strictly and effectively implement the ban on private practice by Govt. doctors, without diluting this order in any manner.

Jan Arogya Abhiyan

(Jan Swasthya Abhiyan – Maharashtra)

Press release –

Regulate Private Hospitals, Protect Patient’s Rights By

Enacting Maharashtra Specific Regulatory Act!

Stop privatization of public health services, ensure essential medicines in all public facilities,

End private practice by government doctors!

Jan Arogya Abhiyan, the State level campaign platform working for Health rights of people in Maharashtra since over a decade, is organizing a protest demonstration on 22nd March, 2013 at Azad Maidan, Mumbai, in collaboration with Anna Adhikar Abhiyan to press for urgent action on important policy demands regarding Health services and Food security in Maharashtra. Around 2000 people from various parts of the state including Right to Food activists, Health rights activists, health professionals and social activists will be participating in this mass protest and ‘Dharana andolan’ to demand prompt action on various outstanding policy issues. In this press release we are describing the context and demands concerning the Health sector, that are being raised in this joint protest on Food security and Health issues.

Jan Arogya Abhiyan’s main demands

Adopt a state specific ‘Maharashtra Clinical Establishments Act’ to regulate private hospitals, based on the national act but with inclusion of provisions for protecting Patient’s rights, along with participatory review and grievance redressal mechanisms.

Stop privatisation of radiological services in Medical college and District hospitals.

Overcome gross shortage of essential medicines in all public health facilities by implementing the ‘Tamil Nadu model’ in comprehensive manner at earliest.

Strictly and effectively implement the ban on private practice by Govt. doctors, without diluting this order in any manner.

Adopt a state specific ‘Maharashtra Clinical Establishments Act’ to regulate private hospitals, with inclusion of provisions for participatory regulation and Patient’s rights.

More than 80% of patients in Maharashtra seek care in private hospitals and clinics, however this sector is today characterized by large scale commercialization and overcharging, lack of effective self regulation by Medical councils, frequent irrational procedures, and violation of patient’s rights. In this context the national ‘Clinical Establishments Act 2010’ is an important step towards standardization of quality and costs of care. However, if Maharashtra government adopts this act in existing form, then due to certain major lacunae in the national act and rules, its implementation would hardly lead to significant benefits for patients or accountability of private hospitals. Rather in absence of accountability mechanisms and participatory forums, it is likely to promote ‘Babu raj’. Hence JAA demands that certain key improvements must be made in the regulatory framework; this is possible only if Maharashtra government adopts its own state specific Clinical Establishment Act, incorporating various positive features of the national act, and adding key provisions to ensure that Patients’ rights are protected and accountability mechanisms are made functional.

Some positive features of the national act, which must be included in the Maharashtra Clinical Establishments Act are:

All private hospitals and clinical establishments (including labs, imaging centres) will have to adopt Standard Treatment Guidelines, and will need to maintain some minimum standards. This would help protect patients from irrational, exploitative treatment and from substandard facilities.

Charges by hospitals will have to be within the range decided by the government, after following consultative process with stakeholders including representatives from doctors. This will check exorbitant charging currently resorted by many doctors.

Clinical establishments will have to display charges for some of the typical main items like consulting charges, room charges etc. This will help patients to know the affordability of each hospital, enabling them to choose hospitals they can afford and have idea in advance of the expected charges.

Jan Arogya Abhiyan welcomes these provisions, and stresses that these must be ensured in the regulatory framework. However we also note that the national act and rules have certain major lacunae such as there is no separate, autonomous structure (and dedicated budget) to ensure implementation of the act; there is no mention of Patient’s rights or any kind of grievance redressal mechanism for patients; there are no district level multi-stakeholder review forums with representation of consumers, patients rights groups or civil society organisations. In this situation, the act is not likely to be effectively implemented, patients’ rights in private hospitals would continue to be sidelined, and since there are hardly any accountability mechanisms regarding the regulatory authority, there is likely to be misuse of powers and corruption, instead of promotion of patients welfare.

Jan Arogya Abhiyan holds that the regulatory framework for Clinical establishments should be accountable and participatory, with involvement of relevant stakeholders; and there should be adequate mechanisms to uphold patient’s rights. If Maharashtra wants to adopt this Central Act, it can do so only in totality, without any significant amendments, due to existing constitutional provisions. However the State government has full constitutional mandate to enact its own health-legislation since health is a state subject. Hence JAA demands the formulation and adoption of a state specific Maharashtra Clinical Establishments Act, based on the current national act but also including provisions for:

Deployment of designated additional regulatory structure, staff and budget to ensure proper implementation of this act

Recognition and protection of patients rights, with clear redressal mechanisms for patients in case their rights are violated or defined rates, standards, protocols are not observed in practice

Multi-stakeholder review bodies at district level, including Patients rights activists and civil society organisations, to ensure accountability and functionality of regulatory authorities

Stop privatisation of Radiological services in Medical college and District hospitals!

The decision of the Maharashtra Government to privatise radiological services in Medical college and District hospitals is retrogressive and unnecessary. Any existing deficiencies in these services should be remedied through appropriate steps and policy decisions; privatisation is not the answer. Continued provision of X-ray and CT scan facilities in district hospitals and above should not be a problem, since radiologists and other technical human power is available in such cities. If no radiologist is available to work full time in these district hospitals and medical college hospitals, some radiologists can be hired on a part time basis. To effect such arrangement of in-sourcing of medical experts, the professional and administrative environment in these Public hospitals would have to be improved considerably by removing bureaucratic obstacles and political interference. The general experience has been that privatisation of healthcare services increases denial of healthcare services to the poor, even if those with BPL cards are supposed to get free services from these privatised facilities, since the genuine poor people are excluded under one pretext or other. Jan Arogya Abhiyan demands that this decision of privatization of radiological services be reversed immediately and corrective steps be taken as mentioned above, so that Public hospitals can provide quality health care services to the people.

Ensure adequate provision of essential medicines in all public health facilities by implementing the ‘Tamil Nadu model’ in comprehensive manner at earliest

Maharashtra’s medicine procurement and distribution system requires complete overhaul to overcome continued gross shortages of medicines in Public health facilities. The current system of procurement is non-transparent and inefficient hence Jan Arogya Abhiyan demands that the tried and tested, renowned system of medicine procurement and distribution in Tamil Nadu should be fully adopted in Maharashtra (with minor modifications if needed), instead of indulging in half-hearted and inadequate initiatives. When states like Kerala and Rajasthan have effectively adopted this model, and other states are in the process, why is Maharashtra Govt. reluctant to go in for an autonomous, transparent procurement body, and pass-book based demand driven distribution system? The inefficient, wasteful and corrupt medicine procurement and distribution system in Maharashtra requires complete overhaul and not half baked, ill conceived experiments.

Government should strictly and effectively implement the ban on private practice by Public doctors, and should not dilute this order in any manner.

Today one reason for decline in people’s confidence in public health facilities is the frequent absence of doctors. Particularly specialist doctors may be often be absent since they are busy in their private practice, even as they draw a full salary from the Government! In this context the State health department has recently taken a positive decision to ban all private practice by Govt. doctors, along with providing 35% additional Non-practicing allowance (NPA). However due to weak implementation of this order, several Govt. doctors continue their private practice. Hence JAA demands strict implementation of this order across the state.

Certain Govt. doctors have reportedly demanded an ‘option’ of not accepting NPA and continuing their private practice, and pressure is being brought on the Health department to allow such relaxation. JAA demands that the Health department should not give in to any such pressures, and should not dilute the ban on private practice or reconsider this key decision.

We would like to note that Jan Arogya Abhiyan had presented all these demands to the Health Minister of Maharashtra, during our protest at Nagpur at time of the Assembly session on 19 December 2012, however no concrete action has been taken by the Government so far. Hence we have planned the protest at Mumbai on 22nd March 2013, by means of which we would like to draw attention of the public to these issues, and assert the need for the Government to address these issues promptly.

Aadhaar/UID is an assault on privacy and citizens rights, it should be boycotted

Sheila Dikshit’s budget speech ignores Punjab & Haryana High Court order, ongoing case in Supreme Court & Parliamentary Committee recommendations
New Delhi: Sheila Dikshit, the Chief Minister of Govt. of NCT of Delhi in her budget speech continues to promote biometric profiling by Aadhaar/Unique Identification (UID) number ignoring Punjab & Haryana High Court order, the ongoing case in Supreme Court, Parliamentary Committee recommendations, concerns of the National Human Rights Commission and protests by citizens. Delhi Government’s decision to make ‘voluntary’ 12 digit number Aadhaar/UID number mandatory is an act of bullying which must be challenged, resisted and boycotted.

Seventeen eminent citizens including Justice A.P. Shah, former Chief Justice of High Court of Delhi and Justice VR Krishna Iyer, former judge, Supreme Court of India have asked for the halting of the Aadhaar/UID project. The entire government machinery is hiding the fact that fundamentally UID is not a proof of identity, it is an identifier contained in the Central Identities Data Repository (CIDR) of (UID)/Aadhaar Numbers.

The Aadhaar is unfolding through an undemocratic process and is primarily aimed at Surveillance, Profiling, Tracking and Convergence. The eminent citizen’s statement read: “This is a project that could change the status of the people in this country, with effects on our security and constitutional rights, and a consideration of all aspects of the project should be undertaken with this in mind.”

In her speech, the Delhi Chief Minister said, “While like the rest of the country we launched Direct Benefit transfer, which has Aadhar linked bank accounts at its core, we have gone further by utilising it for Annshree and Kerosene-free city schemes.”

She added, “…we have succeeded in launching of new plan programmes of “Dilli Annshree Yojana”. 31,617 beneficiaries of this scheme have been covered till mid-March under this Direct Benefit Transfer Aadhar-linked bank account scheme. Cash @ `600 per month has already been transferred to these beneficiaries with effect from April, 2012. Since our technology platform was being rolled out as a pilot, we were not been able to enrol all the eligible in the time frame prescribed. Hence, my government has decided to extend the period up to July 31st 2013, so that all who are enrolled by then would get the benefit from April 2012.”

Referring to Dilli Swavalamban Yojana (DSY) for unorganised and informal sector in terms of numbers of workers and enterprises, a co-contributory pension scheme, in collaboration with the Swavalamban scheme of the Central Government, she said “We will make DSY Aadhar-linked and also ensure universal coverage.”

In two specific orders dated December 18, 2012 and December 20, 2012, Revenue Department of the Delhi government has made Aadhaar mandatory for all citizens who want to access government services like “SC/SC Certificate, OBC Certificate, Domicile Certificate, Income Certificate, Birth Order, Death Order, Surviving Member Certificate, Solvency Certificate, Nationality Certificate, Registration of Marriages under Hindu Marriage Act, Registration of Marriages under Special Marriage Act, Solemnization of Marriages, Registration of various documents in the Sub Registrar’s Office”.The orders are attached. It is noteworthy that the official website of UIDAI has clearly mentioned that, Aadhaar enrolment is voluntaryhttp://uidai.gov.in/what-is-aadhaar-number.html. The Aadhaar Enrollment Form which declares on the top of the form that it is voluntary is attached.

Opposition parties in Delhi appear complicit as they are not asking the glaring question: if Aadhaar is voluntary, why is government finding out ways and means to make it mandatory’?

Delhi citizens and opposition parties are being taken for ride. Congress-led Delhi government has asked the State Election Commission to have provisions for Aadhaar enrolments at the Voters’ Registration Centres (VRCs) across the city and all 70 VRCs across the city are to provide single-window service by enrolling people for Aadhaar from February 25, 2013. Opposition parties should pay heed to the ramifications of some 200 venues in Delhi where Delhi residents are being enrolled for Aadhaar/UID.

In a setback to such undemocratic efforts to bulldoze Aadhaar/UID and related schemes, following the direction issued to the Union of India and Union Territory of Chandigarh by Punjab and Haryana High Court in the matter of Civil Writ Petition 569 of 2013 filed in the High Court against Union of India and others, the Executive Order for making Unique Identification (UID)/Aadhaar mandatory has been withdrawn. In its order the bench of Justice A K Sikri, Chief Justice and Justice Rakesh Kumar Jain dated February 19, 2013 had not noted that the petition “raises a pure question of law.” Since the Executive Order was withdrawn, the case too was disposed of March 2, 2013 with a two page order. The Order observes, “In this writ petition filed as PIL, the petitioner has challenged the vires of notification issued by Union of India for making it compulsory to have UID Cards.”
It is further observed that “Second issue raised in this petition is that vide order dated 5.12.2012, respondent No.3 i.e. Deputy Commissioner, U.T., Chandigarh has given directions to the Branch In charge Registration-cum-Accountant, office of Registering & Licensing Authority, Chandigarh not to accept any application for registration of vehicle and grant of learner/regular driving licence without UID card.” Union Territory of Chandigarh failed to inform the Court the UID is not a card but an identification number based on biometric data without any legal mandate. One of the prayers in the petition in Chandigarh had sought issuance of a writ in the nature of certiorari to quash Executive order dated 5.12.2012 passed by respondent no.3 passed in violation of Motor Vehicles Act, 1988 and Central Motor Vehicle Rules, 1989 vide which UID has been mandatory for the registration of vehicles and grant of learner/ regular driving licence.

In a significant development, P. Karunakaran, Chairperson, Parliamentary Committee on Subordinate Legislation has accepted the petition with regard biometric data collection related to Planning Commission’s Aadhaar/Unique Identification (UID) Number and Home Ministry’s National Population Register (NPR) on March 18, 2013. The petition was submitted by Citizens Forum for Civil Liberties (CFCL), which as earlier given testimony before the Parliamentary Committee that has rejected the UID Bill. The petition before the Parliamentary Standing Committee on Subordinate legislation draws attention towards how all the residents and citizens of India are being made subordinate to prisoner’s status by the ongoing collection of their “biometric information” that includes finger prints, iris scan for permanent storage in a Centralized Identities Data Register (CIDR) and National Population Register (NPR). This is being done ‘as per an approved strategy” by Planning Commission and Union Ministry of Home Affairs without any legal mandate.
In a related development, in an order date December 27, 2012 addressed to Secretary, Union Ministry of Home Affairs, National Human Rights Commission (NHRC) has communicated human rights concerns regarding UID and Radio Frequency Identification (RFID) submitted to it by CFCL. Earlier, NHRC had expressed its deep concerns and apprehensions about UID and “biometric information” in its submission before the Parliamentary Standing Committee on Finance.

In the matter of now rejected National Identification Authority of India (NIAI) Bill, 2010, “NHRC’s views on the NIAI Bill, 2010″ in the Human Rights Newsletter (Vol. 18 No.8, August 2011) reveals that UID/Aadhaar Number has dangerous ramifications is quite relevant in this regard. NHRC’s view was presented to the Parliamentary Standing Committee (PSC) on Finance. The PSC submitted its report to the Parliament on December 13, 2011 rejecting the UID Bill.

Echoing NHRC’s view on “need for protection of information” and “the possibility of tampering with stored biometric information” in paragraph 5 (page no. 7 of the NHRC newsletter) and “disclosure of information in the interest of national security” mentioned in paragraph 9 (page no.8 of the newsletter).
On UID Number, the Draft Paper on Privacy Bill stated, “Data privacy and the need to protect personal information is almost never a concern when data is stored in a decentralized manner. Data that is maintained in silos is largely useless outside that silo and consequently has a low likelihood of causing any damage. However, all this is likely to change with the implementation of the UID Project. One of the inevitable consequences of the UID Project will be that the UID Number will unify multiple databases. As more and more agencies of the government sign on to the UID Project, the UID Number will become the common thread that links all those databases together. Over time, private enterprise could also adopt the UID Number as an identifier for the purposes of the delivery of their services or even for enrolment as a customer.”
The Draft Paper on Privacy Bill discloses, “Once this happens, the separation of data that currently exists between multiple databases will vanish.” This poses a threat to the identity of citizens and the idea of residents of the state as private persons will be forever abandoned.

In view of NHRC’s observation that UID/Aadhaar number will lead to discrimination due to its distinction between residents and citizens in the name of “delivery of various benefits and services” and “weaker sections of society” is quite stark and merits attention of Delhi residents in particular. It has already been admitted that “There is no data protection statute in the country”. In such a scenario gullible citizens are being made to submit their biometric information to illegal and illegitimate entities.

We the undersigned condemn the sinister attempts to malign and hound activists engaged in ensuring justice for the victims of state sponsored violence against the minorities in Gujarat. In what has now become a pattern, powerful vested interests close to the ruling party in Gujarat, have again attacked Teesta Setalvad and Citizens for Justice and Peace (CJP) on charges which are blatantly false and malicious. CJP has already clarified that no one associated with their society has either collected money nor acquired anyone’s land for the Gulberg memorial; the insistence by a section of the press to continue to publish partisan and fabricated reports can only be attributed to ulterior motives.

More than ten years after thousands were killed, maimed, raped and rendered homeless under the watch of a government, these motivated campaigns only point to the continuing impunity at the highest level. The timing of this vicious campaign is all the more significant, as it pre-empts the filing of a protest petition against Narendra Modi by Smt. Zakia Jafri.

We express our solidarity with CJP and appeal to all media houses not to be party to this witch-hunt.